CPT 23480Surgery

Revision of collar bone

CPT code 23480 covers surgical revision of the clavicle (collar bone), typically performed when a previous surgery has failed or complications have occurred requiring correction or reconstruction of the bone.

Showing rates for

National Average

Base Medicare rate

$812.22

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

11.54

PE RVU (NF)

11.21

MP RVU

2.36

Total RVU

25.11

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always append laterality modifier (LT or RT) to avoid automatic denial; this is a CMS requirement for all bilateral codes
Impact: Prevents 100% payment denial and claim rejection; saves average 14-day resubmission delay
Documentbone grafting separately if autograft harvesting performed; bill 20900 (iliac crest) or 20902 (other site) in addition to 23480
Impact: Additional $200-400 reimbursement when autograft harvesting is documented with separate incision and approach
Use modifier 22 with detailed operative note when revision involves extensive bone loss requiring structural grafting or fixation of multiple fragments
Impact: Potential $160-400 additional payment (20-50% increase) with comprehensive documentation comparing to typical case complexity
Verify global period status before billing; 23480 has 90-day global period, so related E/M services within this window are typically bundled
Impact: Prevents denied claims for routine postoperative visits; saves appeals time and write-offs
When hardware removal is the primary reason for revision, ensure documentation supports 23480 over simple removal code 23334
Impact: Difference of $400+ in reimbursement; 23480 ($812.22) versus hardware removal alone (~$350-400)
For ASC settings, confirm facility rate matches physician rate ($812.22) and verify ASC payment separately from physician fee
Impact: Both facility and non-facility rates are identical at $812.22 for 2025, simplifying rate verification

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 23480 in 2025?

The 2025 Medicare national average reimbursement for CPT 23480 is $812.22 for both facility and non-facility settings. This is based on 25.11 total RVUs (11.54 work, 11.21 PE, 2.36 malpractice) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 23480 and 23334?

CPT 23480 is for surgical revision of the clavicle involving correction of nonunion, malunion, or complex reconstruction, while 23334 is simply removal of clavicle hardware. Code 23480 requires documentation of actual bone work beyond hardware removal, such as osteotomy, bone grafting, or debridement of nonunion, and reimburses significantly higher due to greater complexity.

Does CPT 23480 require a laterality modifier?

Yes, CPT 23480 requires either modifier LT (left) or RT (right) to indicate which clavicle was treated. Failing to append the appropriate laterality modifier will result in claim denial or rejection by Medicare and most commercial payers.

Can I bill bone grafting separately with CPT 23480?

Yes, if autogenous bone graft is harvested from a separate donor site (such as iliac crest), you can bill CPT 20900 or 20902 in addition to 23480. However, local bone grafting from the surgical site or use of allograft/bone substitute is typically considered bundled into the revision procedure.

What is the global period for CPT 23480?

CPT 23480 has a 90-day global surgical period, meaning routine postoperative care for 90 days following the procedure is bundled into the surgical fee and cannot be billed separately unless complications arise or unrelated conditions are treated.

How many RVUs is CPT code 23480 worth?

CPT 23480 has 25.11 total RVUs for 2025, consisting of 11.54 work RVUs, 11.21 practice expense RVUs (both facility and non-facility), and 2.36 malpractice RVUs based on the CMS Physician Fee Schedule.

When should I use modifier 22 with CPT 23480?

Use modifier 22 with CPT 23480 when the revision requires substantially greater work than typical, such as extensive scar tissue dissection, multiple osteotomies, structural bone grafting for large defects, or complex reconstruction beyond standard revision. Include a detailed operative report comparing the actual work to typical case complexity and quantifying additional time and difficulty.